Why Does Place Matter? - The association between residential segregation and racial disparities in health is well documented. Our prior research at the HCHDS extended the research literature by finding an association between residential segregation and healthcare utilization. Using data from the 2006 Medical Expenditure Panel Survey, we found that persons living in minority communities had less access to physician care, and used fewer physician, non-physician, mental health, cardiac and diabetes services compared to persons living in majority white communities. However, beyond the racial and ethnic composition of communities little is known about the mechanisms that govern these associations. This project seeks to describe the relationship between place and racial disparities in healthcare use. We want to advance our research by understanding the dynamics of place. What are the characteristics of minority communities that produce disparities in health and healthcare use? This research project proposes three specific aims to answer the question: Why does place matter? Specific Aim 1) To determine if the association between the racial/ethnic composition of neighborhoods and healthcare use can be explained by variations in healthcare provider availability. Specific Aim 2) To examine whether the healthcare use of individuals changes as the racial/ethnic composition of their census tracts changes over time. Specific Aim 3) To determine whether the level of private investment in a community impacts health and healthcare utilization.